What is the Cost to Employers of Direct Medical Care for Chronic Obstructive Pulmonary Disease?

Figures & data

Table 1 Population of COPD patients aged 36 through 64 in employer-insured risk pool (Medstat Marketscan 1999–2003; total number of patients 387,714)

	1999	2000	2001	2002	2003
Number of covered lives	1,881,778	1,906,512	1,982,756	2,784,379	3,664,091
Number of COPD patients (age 36–64)	62,665	58,761	62,414	88,723	115,151
Prevalence of COPD (age 36–64)	3.33	3.08	3.15	3.19	3.14
Prevalence by gender
Male	3.06	2.84	2.88	3.00	2.95
Female	3.57	3.30	3.38	3.34	3.31
Prevalence by age groups
35–44	2.25	2.02	2.02	1.88	1.90
45–54	3.06	2.81	2.87	2.78	2.76
55–64	5.07	4.80	4.85	4.87	4.81
Prevalence by plan types
Fee-for-Service (FFS)	3.51	3.40	4.01	4.15	4.16
Health Maintenance Organizations (HMO)	3.62	3.46	2.94	1.71	2.06
Point of Service (POS)	3.19	2.80	2.90	3.22	2.80
Preferred Provider Organizations (PPO)	3.46	3.18	3.38	3.79	3.50
Point of Service with Capitation (POSC)	2.97	2.69	2.69	2.29	2.35
Prevalence by relation to main beneficiary
Main Beneficiary	3.41	3.14	3.17	3.23	3.18
Spouse	3.18	2.98	3.11	3.11	3.06

Table 2 Mean annual inpatient, outpatient, and emergency department use by persons aged 36 through 64 years with COPD. (Medstat Marketscan 1999–2003; Total number of patients 387,714)¹

Average annual per patient medical utilizations by service type	1999	2000	2001	2002	2003
Hospital admissions	0.10	0.08	0.07	0.06	0.04
Days in hospital for all COPD patients	0.53	0.44	0.33	0.29	0.17
Days in hospital among hospitalized COPD patients	7.78	7.05	6.54	6.07	4.85
Non-emergency outpatient visits	3.45	3.46	3.47	3.72	3.80
COPD prescriptions filled	3.7	4.1	3.75	3.59	3.3
Emergency department visits	0.16	0.21	0.19	0.14	0.13

¹Every inpatient, emergency room or nonemergency room service is due to a primary diagnosis of COPD.

Table 3 Mean annual cost of COPD by service type for patients 36 through 64 years of age. (Medstat Marketscan 1999–2003; total number of patients 387,714)¹

Average annual per patient expenditures^2	1999	2000	2001	2002	2003
Hospital admissions (In 1999 U.S. dollars)	$713 ($713)	$636 ($611)	$522 ($480)	$487 ($427)	$320 ($270)
Outpatient visits per capita (In 1999 U.S. dollars)	$243 ($243)	$251 ($241)	$265 ($243)	$284 ($249)	$295 ($249)
Emergency department visits per capita (In 1999 U.S. dollars)	$256 ($256)	$294 ($283)	$303 ($278)	$302 ($265)	$304 ($256)
Prescription drug expenditures per capita (In 1999 U.S. dollars)	$248 ($248)	$248 ($238)	$249 ($229)	$265 ($233)	$219 ($185)
Totals (In 1999 U.S. dollars)	$1460 ($1460)	$1429 ($1373)	$1339 ($1230)	$1338 ($1174)	$1138 ($960)

¹Annual average costs to a patient for all his/her hospital admissions, outpatient visits, emergency room visits due to a primary diagnosis of COPD.

²This is what insurer pays for all services provided to a patient during each year from 1999 through 2003.

Table 4 Proportion of hospitalization costs with respect to the total medical costs¹ among different age groups for COPD patients 36 through 64 years of age (Medstat Marketscan 1999–2003; total number of patients 387,714)²

Age groups	1999	2000	2001	2002	2003
35–44	27%	15%	19%	16%	15%
45–54	53%	52%	46%	38%	30%
55–64	64%	61%	54%	52%	44%

¹Total annual medical costs include hospitalizations, outpatient services, emergency department use and prescription medicine refills.

²Annual average costs due to a primary diagnosis of COPD.

Table 5 Health care use and cost¹ comparisons of main beneficiaries and spouse for COPD patients aged 36 through 64 years. (Medstat Marketscan 1999–2003; total number of patients 387,714)²

Health care utilization and costs	Main beneficiary	Spouse
Number of hospitalizations	0.06	0.09
Number of days in hospital	0.33	0.46
Number of outpatient non-emergency visits	3.47	3.85
Hospitalization costs	$495.00	$697.00
Outpatient costs	$237.00	$288.00

¹This is what insurer pays for all services provided to a COPD patient from 1999 through 2003.

²These are utilizations and costs due to a primary diagnosis of COPD average over period 1999–2003.

Figure 1 Mean annual costs of COPD by service type for patients 36 through 64 years of age. (Medstat Marketscan 1999–2003; total number of patients 387,714). Annual average costs to a patient for all his/her hospital admissions, outpatient visits, emergency room visits due to a primary diagnosis of COPD.